19 August 2021
Name: Mia Biondi
Location: Ontario, Canada
Organisation: Researcher, Toronto Centre for Liver Disease, Toronto General Hospital, Adjunct Research Professor, Western University, Part-Time Teaching Faculty, McMaster University, NP, Omega Specialty Nurses
Specialisms: HCV, HIV, virology
Tell us a bit about your background. You are a nurse practitioner but also a researcher – how do these combined mindsets and skills benefit your work?
At heart, I am a virology nerd. I was trained in basic science first, studying HIV and HCV mechanisms of drug resistance. I loved being on the bench and in the lab. I knew however that I also ultimately wanted to be a clinician, so decided to become a Registered Nurse (RN) and then later a Nurse Practitioner (NP).
As an RN, I sought out clinical areas that I was interested in and was able to really diversify my clinical knowledge in formal clinical settings such as mental health, sexual health, and pediatrics, as well as volunteer and work for several non-profit organizations where I saw people in a drop-in setting. These experiences gave me a solid grounding for practicing as a primary care NP with focused practices in HIV prevention and viral hepatitis.
I’ve been really lucky to have mentors who have guided me through the transition to clinical research and am very fortunate to be on several fantastic teams (all of whom put up with listening to my ideas). Currently, much of my research is related to gaps seen in clinical practice for providers and patients.
One of the reasons I am so involved in research is so I can avoid getting “stuck” in clinical practices. If you are a service provider and interested in research – jump in and get involved. I hope to see more nurses and people with lived experience leading research studies in the very near future.
What is the topic most on your mind at the moment when considering the health of people who use drugs?
I grew up in a small town in Ontario, Canada, and am currently very involved in facilitating low-barrier care for HCV treatment. However, people in smaller communities (at least in Ontario) have a very difficult time obtaining enough harm reduction equipment. Even service providers are limited in the amount of supplies they are able to obtain and distribute. There is not the same emphasis as there is in larger cities to provide drug use equipment or overdose prevention sites. Unfortunately, many of these communities have suffered great loss as the result of overdoses, which has certainly worsened during COVID. Increasing harm reduction services to smaller communities is needed.
You’re passionate about re-framing models of care. Could you explain what you mean by this and how it could make a difference to the health of people who use drugs?
HCV treatment has evolved from a very challenging treatment course for patients and providers, to well-tolerated, oral medication, that is fairly easy to prescribe. In the past, a large multi-disciplinary team was needed to start and monitor treatment, while now a single provider can manage care. However, because treatment is so straightforward, it means that anyone awaiting all-oral treatment has likely been cured. So while before the clinical team was quite large, we can now shift to have a small clinical team, but need a much larger outreach team.
Caseworkers, staff who serve at risk populations, peers, and those with lived experience are an essential part to engaging those at-risk of HCV. Without real community partnerships we won’t be able to co-localize HCV care or gain the trust of the people we are trying to engage.
Why should someone join INHSU?
INHSU likely has some of the best resources I’ve seen globally for working with those who use drugs and co-localizing care; and often they are region-specific. As a member, I have enjoyed meeting people from the same profession from other countries, and INHSU facilities those connections and knowledge exchange.